論文

査読有り 筆頭著者 国際誌
2021年5月

Glucose Metabolism After Pancreatectomy: Opposite Extremes Between Pancreaticoduodenectomy and Distal Pancreatectomy

The Journal of Clinical Endocrinology & Metabolism
  • Fumimaru Niwano
  • ,
  • Naru Babaya
  • ,
  • Yoshihisa Hiromine
  • ,
  • Ippei Matsumoto
  • ,
  • Keiko Kamei
  • ,
  • Shinsuke Noso
  • ,
  • Yasunori Taketomo
  • ,
  • Yoshifumi Takeyama
  • ,
  • Yumiko Kawabata
  • ,
  • Hiroshi Ikegami

106
5
開始ページ
e2203
終了ページ
e2214
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1210/clinem/dgab036
出版者・発行元
The Endocrine Society

<title>Abstract</title>
<sec>
<title>Context</title>
The rate of glucose metabolism changes drastically after partial pancreatectomy.


</sec>
<sec>
<title>Objective</title>
This work aims to analyze changes in patients’ glucose metabolism and endocrine and exocrine function before and after partial pancreatectomy relative to different resection types (Kindai Prospective Study on Metabolism and Endocrinology after Pancreatectomy: KIP-MEP study).


</sec>
<sec>
<title>Methods</title>
A series of 278 consecutive patients with scheduled pancreatectomy were enrolled into our prospective study. Of them, 109 individuals without diabetes, who underwent partial pancreatectomy, were investigated. Data were compared between patients with pancreaticoduodenectomy (PD, n = 73) and those with distal pancreatectomy (DP, n = 36).


</sec>
<sec>
<title>Results</title>
Blood glucose levels during the 75-g oral glucose tolerance test (75gOGTT) significantly decreased after pancreatectomy in the PD group (area under the curve [AUC] –9.3%, P &amp;lt; .01), and significantly increased in the DP population (AUC + 16.8%, P &amp;lt; .01). Insulin secretion rate during the 75gOGTT and glucagon stimulation test significantly decreased after pancreatectomy both in the PD and DP groups (P &amp;lt; .001). Both groups showed similar homeostasis model assessment of insulin resistance (HOMA-IR) values after pancreatectomy. Decrease in exocrine function quality after pancreatectomy was more marked in association with PD than DP (P &amp;lt; .01). Multiple regression analysis indicated that resection type and preoperative HOMA-IR independently influenced glucose tolerance-related postoperative outcomes.


</sec>
<sec>
<title>Conclusions</title>
Blood glucose levels after the OGTT differed markedly between PD and DP populations. The observed differences between PD and DP suggest the importance of individualization in the management of metabolism and nutrition after partial pancreatectomy.


</sec>

リンク情報
DOI
https://doi.org/10.1210/clinem/dgab036
URL
http://academic.oup.com/jcem/advance-article-pdf/doi/10.1210/clinem/dgab036/36250509/dgab036.pdf
URL
http://academic.oup.com/jcem/article-pdf/106/5/e2203/37307889/dgab036.pdf
ID情報
  • DOI : 10.1210/clinem/dgab036
  • ISSN : 0021-972X
  • eISSN : 1945-7197

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